Metabolic Syndrome and Positive Frailty Screening: A Cross-Sectional Study with Community-Dwelling Older Adults.

Background: Metabolic Syndrome is a set of disorders that characterized by the association of three or more risk factors, like the obesity central, dyslipidemia, borderline blood pressure, hyperglycemia, and the increase of triglycerides. However, these factors also can be associated with pathophysiology of frailty. Objectives: verifying whether the metabolic syndrome is associated to the positive frailty screening in the older people. Design: Cross-sectional study. Participants: 443 older people living in Rio Branco, Brazil. Setting: Data collection was carried out in two stages: a personal interview and blood collection. Measurements: The diagnosis of metabolic syndrome was based on the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. The frailty screening was performed using subjective questions validated in a previous study. Descriptive statistics and multinomial logistic regression were used for data analyses. Results: There was a predominance of female older people (69.07%), aged between 60 and 79 years (87.13%), with an income greater than or equal to one minimum wage (72.09%), no cognitive decline (75.94%) and depressive symptoms (63.31%), independent for BADL (86.46%) and dependent for IADL (51.69%). From the total sample, 56.88% of the older people were identified as frail, 34.09% pre-frail and 9.03% non frail. The prevalence of metabolic syndrome was 51.69%. After adjusting by the independent variables, an association between metabolic syndrome and pre-frailty was observed, and older people with metabolic syndrome were more likely to be prefrail (RRR=2.36; 95%CI=1.08-5.18). Conclusion: The metabolic syndrome was associated to the increase chance of screening for prefrailty in the older people evaluated, which reinforces the needy to establish preventive measures in relation to the metabolic syndrome to avoid frailty in the older people.

Calcicole behaviour of Callisthene fasciculata Mart., an Al-accumulating species from the Brazilian Cerrado.

Most aluminium (Al)-accumulating species are found on soils with high Al saturation and low Ca availability (Ca poor). Callisthene fasciculata Mart. (Vochysiaceae), however, is an Al-accumulating tree restricted to Ca-rich soils with low Al saturation in the Brazilian Cerrado savanna. Here we tested its calcicole behaviour, and the possible role of organic acids in detoxification of Al during the early stages of plant development. We assessed growth, dry mass, nutrients, Al and organic acids in seedlings grown for 50 days on two contrasting Cerrado soils; one with high Ca concentrations and low Al saturation and the other with low Ca availability and high Al saturation. Relative to plants on Ca-rich soil, plants on Ca-poor soil had necrotic spots and bronzing of leaves. Roots and shoots contained reduced concentrations of P and Cu, but higher concentrations of Fe, Al and citrate. Despite lower concentrations in the soil, Ca and Mg increased in shoots. Shoot concentrations of oxalate were also higher. We confirmed C. fasciculata as an Al-accumulating species with calcicole behaviour. The increased concentrations of organic acids in plants with higher Al accumulation suggest that high availability of soluble Al does not prevent occurrence of this species on soils with high Al saturation. Instead, the absence of C. fasciculata from Ca-poor soils is probably due to imbalances in tissue Fe, Cu and Zn imposed by this soil type.

Modeling the dynamics of BMI changes during adolescence. The Oporto Growth, Health and Performance Study.

OBJECTIVES: The aims of this study were twofold: (i) to model changes in body mass index (BMI) of 10-18-year-old adolescents, and (ii) to investigate the effects of total physical activity (TPA), physical fitness (PF), sleep duration and fruit/vegetable consumption in BMI trajectories across time. METHODS: Data were obtained from the Oporto Growth, Health and Performance Study and comprised 6894 adolescents (3418 girls) divided into four age cohorts (10, 12, 14 and 16 years) measured annually for 3 years. BMI was computed using the standard formula (kg m(-2)); TPA was estimated with the Baecke questionnaire; PF measures included 1-mile run/walk, 50 yard dash (50YD), standing long jump (SLJ), handgrip strength (HGr) and agility shuttle run. Longitudinal changes in BMI were analyzed using the multilevel modeling approach. RESULTS: The average BMI at age of peak of height velocity was 20.7±0.07 kg m(-2) for girls (P<0.001) and 20.58±0.06 kg m(-2) for boys (P<0.001). The annual increment in BMI was 1.36±0.04 kg m(-2), P<0.001 and 1.23±0.03 kg m(-2), P<0.001 for girls and boys, respectively. PF were related to BMI trajectories in both sexes (Girls: ß1mile=0.12±0.02, P<0.001; ßSLJ=-0.01±0.00, P<0.001; ß50YD=0.28±0.05, P<0.001; ßHGr=-8.91±0.54, P<0.001; Boys: ß1mile=0.18±0.02, P<0.001; ßSLJ=-0.01±0.00, P<0.001; ß50YD=0.26±0.04, P<0.001; and ßHGr=-8.15±0.45, P<0.001). TPA only showed significant, but positive, association with girls' BMI trajectories (ß=0.10±0.03, P=0.001). After adjusting for the covariates, sleep duration and fruit/vegetable intake did not show any significant association with BMI trajectories either sex. CONCLUSIONS: BMI increased linearly with age in both gender. PF levels are negatively associated with BMI across time in both boys and girls. Therefore, promotion of PF in the adolescent years seems to be effective in the early prevention of obesity.

New species of Eimeria and Isospora (Protozoa: Eimeriidae) in Geochelone spp. (Chelonia: Testudinidae) from Amazonian Brazil.

Tetrasporocystic, dizoic oocysts of reptiles have been separated by some authors into the genera Eimeria, Choleoeimeria and Acroeimeria (Protozoa: Eimeriidae), based on the site and mode of development of their endogenous stages. The majority of Eimeria species have been, and still are, however, described on oocyst morphology alone. Four different oocysts with this basic morphology were encountered in the faeces of Brazilian tortoises, Geochelone carbonaria Spix, 1824 and are assigned to the genus Eimeria, with the view that they can readily be transferred to the genus Choleoeimeria or Acroeimeria if this is indicated by a future examination of their endogenous development. A morphological comparison distinguishes the oocysts from those of Eimeria spp., previously described in chelonids of the family Testudinidae, and the names E. amazonensis, E. carbonaria, E. carajasensis and E. wellcomei n. spp. are proposed. Coccidial infection appears to be common in G. carbonaria, with three of seven animals examined passing oocysts. Oocysts of Isospora rodriguesae n. sp. (Protozoa: Eimeriidae) are described in the faeces of Geochelone denticulata Linnaeus, 1766. They are morphologically very different from those of Isospora testudae, Davronov, 1985 in Testudo horsfieldi. Eimeria motelo Hurková et al., 2000, previously described in Geochelone denticulata from Peru, is here recorded in the some chelonid from Amazonian Brazil.

The chloroxoquinolinic derivative 6-chloro-1,4-dihydro-4-oxo-1-(beta-D-ribofuranosyl) quinoline-3-carboxylic acid inhibits HSV-1 adsorption by impairing its adsorption on HVEM.

In this paper, we describe that the oxoquinolinic acid derivative (compound A) inhibited HSV-1 adsorption on Vero cells. This effect was achieved with an EC(50) value of 10 +/- 2.0 microM and with low cytotoxicity, since the CC(50) value for compound A was >1000 microM. Moreover, we demonstrate for the first time that adsorption inhibition was due to the blockage of the interactions between HSV-1 and the cellular receptor herpes virus entry mediator (HVEM). These results show that compound A can prevent HSV-1 infection in Vero cells, encouraging further studies to determine at what level compound A inhibits HSV-1-HVEM interactions.

Vibrational normal modes of diazo-dimedone: a comparative study by Fourier infrared/Raman spectroscopies and conformational analysis by MM/QM.

The 2-diazo-5,5-dimethyl-cyclohexane-1,3-dione (3) was synthesized and the FT-IR/Raman spectra were measured with the purpose of obtain a full assignment of the vibrational modes. Singular aspects concerning the -CNN oscillator are discussed in view of two strong bands observed in the region of 2300-2100 cm(-1) in both, Infrared and Raman spectra. The density functional theory (DFT) was used to obtain the geometrical structure and for assisting in the vibrational assignment joint to the traditional normal coordinate analysis (NCA). The observed wavenumbers at 2145 (IR), 2144(R) are assigned as the coupled nu(NN)+nu(CN) vibrational mode with higher participation of the NN stretching. A 2188 cm(-1) (IR) and at 2186 cm(-1) (R) can be assigned as a overtone of one of nu(CC) normal mode or to a combination band of the fundamentals delta(CCH) found at 1169 cm(-1) and the delta (CCN) found at 1017 cm(-1) enhanced by Fermi resonance.

Natural and experimental infection of the lizard Ameiva ameiva with Hemolivia stellata (Adeleina: Haemogregarinidae) of the toad Bufo marinus.

Developmental stages of a haemogregarine in erythrocytes of the lizard Ameiva ameiva (Teiidae), from Pará State, north Brazil, were shown to be those of Hemolivia by the nature of the parasite's sporogonic cycle in the tick Amblyomma rotondatum. The type species, Hemolivia stellata Petit et al., 1990 was described in the giant toad Bufo marinus and the tick Amblyomma rotondatum, also from Pará State, and in view of the fact that A. ameiva and Bufo marinus share the same habitat and are both commonly infested by A. rotondatum, the possibility that the parasite of A. ameiva is H. stellata had to be considered. Uninfected lizards fed with material from infected ticks taken from B. marinus, and others fed with liver of toads containing tissue-cysts of H. stellata, were shown to subsequently develop typical Hemolivia infections, with all stages of the development similar to those seen in the naturally infected lizards. Conversely, a juvenile, uninfected toad became infected when fed with sporocysts of Hemolivia in a macerated tick that had fed on an infected A. ameiva and pieces of liver containing tissuecysts from the same lizard. The remarkable lack of host specificity shown by H. stellata, in hosts so widely separated as an amphibian and a reptile, is discussed.

Unexpected benefit of sorbitol placebo in Mg intervention study of premenstrual symptoms: implications for choice of placebo in RCTs.

We carried out a randomized, double-blind, crossover study of 85 women, designed to investigate the dose-response of daily Mg supplementation on premenstrual symptoms. Each woman took one of four treatments: Mg (200, 350 or 500 mg/day) or sorbitol (placebo) for 2 months. This was followed by a washout of 1 month, and then each woman received one of the three remaining treatments for a further 2 months. Unexpectedly, sorbitol (1305 mg) reduced anxiety-related and total premenstrual symptoms after 2 months compared with Mg treatments (P<0.001 and P<0.001, respectively). We conclude that low-dose sorbitol reduces premenstrual symptoms beyond that expected of a placebo. After 2 months of treatment, sorbitol also reduced urinary Mg excretion compared to baseline (no intervention) and Mg treatments (P=0.005). A follow-up study on 17 healthy volunteers confirmed lack of effect on urinary Mg output of a similar sorbitol intervention regime compared with either baseline or cellulose placebo. It appears that sorbitol may influence Mg homeostasis in women suffering premenstrual symptoms, but not in healthy individuals. Implications for placebo choice in RCTs are discussed.

Synthesis of 4-acyl-1H-1,2,3-triazolic nucleosides.

Two simple regiospecific methodologies based on triazolic ring construction in the course of synthesis were applied for the synthesis of 1,2,3triazolic nucleoside analogues. The cycloaddition reactions between diazomalonaldehyde and appropriate glycosylamine derivatives were rather effective, producing the desired nucleosides 11, 17 and 24. Diazotization of enamines 21a and 21b led to the corresponding triazolic ribonucleoside derivatives 22a and 22b, in good yields. Deprotection reaction of 22a, 22b and 24 was easily achieved by Lewis acid catalysis, producing the corresponding ribonucleosides 23a, 23b and 25.

A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study.

To investigate single and combined effects of daily dietary supplementation with 50 mg of vitamin B6 and 200 mg magnesium (as MgO) for one cycle for the relief of mild premenstrual symptoms, a randomized, double-blind, placebo-controlled, crossover design was used. Forty-four women with an average age of 32 years took part in the study. Each woman was randomly assigned, according to a Latin square design, to take consecutively all four of the following treatments daily for one menstrual cycle: (1) 200 mg Mg, (2) 50 mg vitamin B6, (3) 200 mg Mg + 50 mg vitamin B6 and (4) placebo. Throughout the study, each volunteer kept a daily record of symptoms using a 5-point ordinal scale in a menstrual diary of 30 symptoms. Symptoms were grouped into six categories: anxiety, craving, depression, hydration, other, and total. Urinary magnesium output for 24 hours was estimated using the Mg/creatinine concentration ratio. ANOVA showed no overall difference between individual treatments, but predefined treatment comparisons using factorial contrasts in ANOVA showed a significant effect of 200 mg/day Mg + 50 mg/day vitamin B6 on reducing anxiety-related premenstrual symptoms (nervous tension, mood swings, irritability, or anxiety) (p = 0.040). Urinary Mg output was not affected by treatment. A small synergistic effect of a daily dietary supplementation with a combination of Mg + vitamin B6 in the reduction of mild premenstrual anxiety-related symptoms was demonstrated during treatment of 44 women for one menstrual cycle. In view of the modest effect found, further studies are needed before making general recommendations for the treatment of premenstrual symptoms. The study indicated that absorption from MgO was poor and daily supplementation for longer than 1 month is necessary for tissue repletion.

Magnesium supplementation alleviates premenstrual symptoms of fluid retention.

We investigated the effect of a daily supplement of 200 mg of magnesium (as MgO) for two menstrual cycles on the severity of premenstrual symptoms in a randomized, double-blind, placebo-controlled, crossover study. A daily supplement of 200 mg of Mg (as MgO) or placebo was administered for two menstrual cycles to each volunteer, who kept a daily record of her symptoms, using a 4-point scale in a menstrual diary of 22 items. Symptoms were grouped into six categories: PMS-A (anxiety), PMS-C (craving), PMS-D (depression), PMS-H (hydration), PMS-O (other), and PMS-T (total overall symptoms). Urinary Mg output/24 hours was estimated from spot samples using the Mg/creatinine ratio. Analysis of variance for 38 women showed no effect of Mg supplementation compared with placebo in any category in the first month of supplementation. In the second month there was a greater reduction (p = 0.009) of symptoms of PMS-H (weight gain, swelling of extremities, breast tenderness, abdominal bloating) with Mg supplementation compared with placebo. Compliance to supplementation was confirmed by the greater mean estimated 24-hour urinary output of Mg (p = 0.013) during Mg supplementation (100.8 mg) compared with placebo (74.1 mg). A daily supplement of 200 mg of Mg (as MgO) reduced mild premenstrual symptoms of fluid retention in the second cycle of administration.

Steroidal alkaloid glycosides from Solanum orbignianum.

Aerial parts of Solanum orbignianum afforded a new steroidal alkaloid glycoside, leptinidine 3-O-beta-D-glucopyranoside, together with the known alkaloids leptinidine, leptinine I and leptinine II. Their structures were established by spectroscopic methods.

Validation of national algorithms for the diagnosis of sexually transmitted diseases in Brazil: results from a multicentre study.

OBJECTIVE: To validate STD flow charts for the management of genital discharge and genital ulcer currently recommended by the National STD Control Programme in Brazil. METHODS: A study was conducted in five Brazilian STD clinics from January to June 1995. After an interview, a clinical examination was performed by a physician, who recorded a presumptive diagnosis, based on his/her clinical experience. This diagnosis was compared with a gold standard laboratory diagnosis in order to calculate sensitivity, specificity, and positive predictive value of the clinical diagnosis. The validity of the simulated national flow charts was assessed using the same method. RESULTS: A total of 607 men and 348 women participated in the study. Gonorrhoea was the aetiology most frequently detected in men with urethral discharge. The sensitivity of the clinical diagnosis was far lower than the sensitivity fo the national flow chart, using the syndromic approach, for both gonococcal and chlamydial urethritis. Adding a simple laboratory test (Gram stain) to the national flow chart increased the specificity and positive predictive value for gonorrhoea. Among the women with vaginal discharge, a cervical infection was detected in 17%, a vaginal infection in 74%, and mixed infection in 9%. The sensitivity of the diagnosis for cervical infection increased from 16% (clinical aetiological approach) to 54% (when adding a syndromic approach) and to 68% when adding a risk assessment, as in the national flow charts. The cure or improved rate of genital ulcers was 96% after 1 week. CONCLUSIONS: The results of the study will help to convince policy makers and those involved in training healthcare workers in Brazil of the public health advantages of the syndromic approach, as an essential part of STD/HIV control activities.

[Partial ventriculectomy in a child--the Batista technique]. / Ventriculectomia parcial em criança--técnica de Batista.

We present the case of a two and a half year old child with idiopatic dilated cardiomyopathy and end-stage congestive heart failure (NYHA III-IV) who underwent "partial ventriculectomy". The operation was performed under normothermic cardiopulmorary bypass and normothermic oxygenated blood cardioplegia and consisted of removal of a large wedge of muscle from the lateral wall of the left ventricle beginning at the apex and extending between the papillary muscles, ending proximal to the mitral annulus. Pre-operative the left ventricular ejection fraction (EF) was 13% by echocardiography and 20% by radionuclide ventriculography. Postoperative avaliation showed improvement of EF to 50% and 30%, respectively. The child was in functional class I (NYHA) on discharge from hospital (16th postoperative day).

Comparative study of adenoviruses with monoclonal antibodies.

The obtainment of monoclonal antibodies for adenovirus species 4(Ad4) is described. The specificities of selected monoclonal antibodies were determined by means of viral neutralization test in cell culture, immunofluorescence and Enzyme-Linked Immunosorbent Assay (ELISA), in the presence of the following species of human adenovirus: 1, 2, 5 (subgenus C), 4 (subgenus E), 7 and 16 (subgenus B) and 9 (subgenus D). Two monoclonal antibodies species specific to adenovirus 4 (1CIII and 3DIII) and one monoclonal antibody that cross reacted with adenovirus species 4 and 7 (2HIII) were obtained.

[Detection of bacterial antigens in acute pneumonia: methods of preparing the urine, serum, and pleural fluid samples for immunodiagnostic assays]. / Detecção de antígenos bacterianos em pneumonia aguda: métodos de preparação das amostras de urina, soro e líquido pleural para os testes de imunodiagnóstico.

A method of polysaccharide antigen precipitation in urine treated with 1:1 ethanol-acetone solution, followed by heat treatment with 0.1 M EDTA were developed for detection of S. pneumoniae and H. influenzae type b. Counterimmunoelectrophoresis and latex agglutination were employed to detect the antigens, in paired samples of urine and serum, and also in pleural fluid samples from children with clinical diagnosis of acute pneumonia. Counterimmunoelectrophoresis and latex agglutination showed better results in urine than in serum and also in smaller initial volumes of urine from the onset of illness or during the first days of antibiotic therapy. The results obtained in counterimmunoelectrophoresis and latex agglutination showed that ethanol-acetone solution increased the yield of polysaccharide antigen precipitation while heating with EDTA diminished the probability of false-positive results and cross-reactivity between S. pneumoniae and H. influenzae type b. The results, statistically evaluated, suggest that urine is a body fluid in which the bacterial antigens may be detected in the acute pneumonia. This is of importance in patients previously treated with antibiotics which may inhibit bacterial growth in the culture media.